D. Chassard et al., GASTRODUODENAL TOLERANCE TO METHYLPREDNIS OLONE - ORAL VERSUS INTRAVENOUS ADMINISTRATION IN HEALTHY VOLUNTEER, La Presse medicale, 23(11), 1994, pp. 515-517
Objectives: To endoscopically evaluate the tolerance of gastroduodenal
mucosa to methylprednisolone given orally and intravenously. Methods:
Thirty two healthy volonteers (age range 18-39 years) were divided ra
ndomly into two groups of 16 each (8 males and 8 females). All were Ca
ucasians, gave their informed consent and were considered normal after
a complete clinical and laboratory work-up including gastroduodenal f
ibroscopy. Methylprednisolone (500 mg) was administrated for three con
secutive days at 9 a.m., orally in one group and intravenously in the
second group. No other drugs were being taken and alcohol and smoking
were prohibited from day 0 to day 11. Tolerance was evaluated on days
4 and 11 based on clinical examination, blood pressure, heart rate, or
al temperature, body weight, blood and urine chemistry and by video-re
corded gastroduodenal endoscopy. Two independent endoscopists, uninfor
med of the patient's regimen, scored lesions from 0 (normal) to 5 (mor
e than 25 lesions including at least 2 erosions). In case of abnormal
findings, follow-up was continued to normalization. Results: Endoscopi
cally detectable lesions (stage I) attributed to corticosteroid therap
y were observed in 4 subjects in the oral group and in 5 in the intrav
enous group. All regressed spontaneously. Duodenal lesions were observ
ed only after oral administration while lesions of gastric mucosa were
mostly found after intravenous administration. Systemic effects inclu
ded abdominal pain after oral intake, 1 case of insomnia and bitter ta
ste in the mouth after intravenous administration. Conclusions: These
findings suggest that the effect of corticosteroid therapy, on the gas
tric mucosa, is basically systemic, and on the duodenal mucosa, basica
lly local. No severe manifestations were observed after high-dose meth
ylprednisolone given orally or by intravenous injection.